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持续性菌血症罕见病例:无导线Micra起搏器心内膜炎。

A Rare Case of Persistent Bacteremia: Leadless Micra Pacemaker Endocarditis.

作者信息

Patel Himax, Harrell Sean, Hreibe Haitham, Sharkawi Musa, AlJaroudi Wael

机构信息

Augusta University Medical Center, 1120 15th Street, Augusta, GA 30912, USA.

出版信息

Case Rep Cardiol. 2023 Jan 18;2023:8326020. doi: 10.1155/2023/8326020. eCollection 2023.

Abstract

Leadless pacing systems have revolutionized the field of electrophysiology given its low complication rates and almost non-existent rate of infections compared with traditional pacemakers. These devices boast resistance to infections given its unique features; however, as described in this report, device-related infection from these leadless devices is still possible. In patients with leadless pacing system that is persistently bacteremic in the future, evaluation of the device with transesophageal echocardiogram or intracardiac echocardiography should be performed, and if vegetation is noted on the device, device extraction should highly be considered, along with empiric intravenous antibiotics. Lastly, new leadless device should not be re-implanted within 2 weeks of the removal of the infected device to prevent seeding of the new device.

摘要

无导线起搏系统彻底改变了电生理学领域,因为与传统起搏器相比,其并发症发生率低且几乎不存在感染率。这些设备因其独特的特性而具有抗感染能力;然而,正如本报告中所描述的,这些无导线设备仍有可能发生与设备相关的感染。对于未来持续菌血症的无导线起搏系统患者,应行经食管超声心动图或心腔内超声心动图对设备进行评估,如果在设备上发现赘生物,应高度考虑取出设备,并给予经验性静脉抗生素治疗。最后,在取出感染设备后的2周内不应重新植入新的无导线设备,以防止新设备感染。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/67f7/9876663/84ad9ad49dae/CRIC2023-8326020.001.jpg

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